BURL2019-000778-495 CALLE TAMPICO Tity/ D w*P Qu&M VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 FAX (760) 777-7011
DESIGN & DEVELOPMENT DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
Permit Type/Subtype: ELECTRICAL - UTILITY (IID) RELEASE (WEB)/ Owner:
Application Number: BURL2019-0007 LA QUINTA PALMS
Property Address: 79355 HORIZON PALMS CIR
APN: 604110048 LA QUINTA, 92253
Application Description: LA QUINTA PALMS / IID RELEASE
Property Zoning:
Application Valuation:
Applicant: Contractor:
TUCK ELECTRIC r� TUCK ELECTRIC
42661 HASTINGS ST MAR U 6 1, 42661 HASTINGS ST
PALM DESERT, CA 92211 PALM DESERT, CA 92211
CITYORAQU1W. (760)408-0228
Llc. No.: 1036254
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and
my License is in full force and effect.
License Class: C10 License No.: 1036254
r�
Date. Contractqf!x
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair any
structure, prior to its issuance, also requires the applicant for the permit to file a signed
statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that he
or she did not build or improve for the purpose of sale.).
(_) I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project. (Sec. 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an owner of property who builds or improves thereon,
and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractors' State License Law.).
(_) I am exempt under Sec. B.&P.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ_ C.).
Lender's Name'
Lender's
Date: 3/6/2019
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of rk for which this permit is issued. tj�
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My workers' compensation insurance carrier and policy number are:
Carrier: MARKEL INSURANCE COMPANY Policy Number: MWC013144801
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 ofthe Labor Code, I shall forthwith
comply with those provisions.
alill 3 ` �1 ! Appllcantc
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit issued
as a result of this application , the owner, and the applicant, each agrees to, and shall
defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not
commenced within 180 days from date of issuance of such permit, or cessation of work
for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter upon the above -
mentioned property for inspection purposes.
Date:—�+6?A��i,Signature(ApplicantorAgen0.
[late: 3/6/2019
Application Number:
Property Address:
APN:
Application Description
Property Zoning:
Application Valuation:
Applicant:
TUCK ELECTRIC
42661 HASTINGS ST
PALM DESERT, CA 92211
BURL2019-0007
79355 HORIZON PALMS CIR
604110048
LA QUINTA PALMS / IID RELEASE
Owner:
LA QUINTA PALMS
LA QUINTA, 92253
Contractor:
TUCK ELECTRIC
42661 HASTINGS ST
PALM DESERT, CA 92211
(760)408-0228
Llc. No.: 1036254
Detail: IID RELEASE FOR BREAKEWR REPLACEMT ONLY. NOT OTHER WORK FOR PERMIT. P`ER 2016,CALIFORNIA BUILDING CODES
DESCRIPTION
FINANCIAL
INFORMATION
ACCOUNT CITY
AMOUNT
Credit Card Fee
101-0000-43505 0
$1.53
Total Paid for Credit Card Fee:
$1.53
DESCRIPTION
ACCOUNT QTY
AMOUNT
ELECTRICAL - UTILITY RELEASE
101-0000-42400 0
$80.05
Total Paid for ELECTRICAL - UTILITY RELEASE:
$80.05
DESCRIPTION
ACCOUNT
CITY
AMOUNT
TECHNOLOGY ENHANCEMENT FEE
502-0000-43611
0
$5.00
Total Paid for TECHNOLOGY ENHANCEMENT FEE:
TOTALS:
$5.00
11D IMPERIAL IRRIGATION DISTRICT
PO BOX 937 + 333 EAST SARIONI BLVD a IMPERIAL CA 92251-0937
800.303.7708 760.33S.3640 Fax 760,339.9471 Wabaite www-ild.co n
ayola Electric Bill
See br/ling inlormalion on reverse side
Customer: LA QUINTA PALMS HOA
Service Address: 79355 HORIZON PALMS CIR LA nUINTA CA 3� Invoice Date: 12123/2018
Contract Account: 50056681 Business Partner: 3011766 Electric Rate: EL_SM_COM
Page• 1 of 1
^, .Your Motor Reading Results....
Meter Service Dates Number Prior I Current Multiplierl Consumption
Number From To of Days 1. Reading Reading I (Kvvh/KwlKvar)
110-1 B4B-266264 1 1/20/2013 12/ 1912018 I 30 1 10,A53 1 11.760
CURRENT BILLING
Previous Balance
Payments Received by 1212312018, Thank You.
Balance
Customer Charge
Consumption 11,000 KWH@$0.1231/KWH)
Consumption (107 KWH aQS0.1205/KWH)
Energy Cost Adjustment Non -Renewable $0.0191-/kWh
Energy Cost Adjustment Renewable 40.0142 JkWh
Total Energy Cost Adjustment (1,107/kWh) $0.0049-
State Mandated Charges: Public Benefits Charge(S142.57 0$.0286)
California Energy Surcharge (1,107 KWH@$0.00029/KWH)
1,107
AM9IJNT
$157.69
157&29CR
0.00
12.00
123.10
12.89
5.4ZCR
4.06
0.32
Total Current Charges Due by 0111412019 146.95
Account Balance $146.95
We appreciate your participation in the EZ Pay Program. The amount due will be automatically deducted from
your bank account on 01114/2019.
...Important IniormationlMouseges... �
Your nett meeeF reading wi)I be on 01122/2019,
Your payment will be deducted from your bank on 01114/2019.
...Your Consumption History...
Days of
SE -ice
Consumption
--(KWEI)
Average Deily
usage
Current
Month
30
1,107
38.90
Prior month
This year
32
1.189
37.16
same month
Last Year
30
1,170
39.00
Electrical Rate Disclosure:
eneretior .0�d.06696 -
Transmission 0.01231 0.01205
Distribution 0,02339 0.02290
Totel Retoll(VM 00.12310 80-12060
..Graph of Your Monthly Consumption History...
KWH _
t , 300
1,040
7S0
620
26D
UT
0 DEC JANFEBMARpp PR MAP" JULq
UOSEP OCTNO"Curr
Cafac,n two and mium bar/Om rr4n tr/lh pnr...,i
_ pv yuvrw ueymvrrt.
REMITTANCE PORTION
IMPERIAL IRRIGATION DISTRICT
PO BOX 937 . 333 EAST BARIONI BLVD a IMPERIAL CA 02251-0937
IF PAYING IN PERSON, PLEASE BRING THE ENTIRE BILL.
CHECK PAYMENTS WILL BE ELECTRONICALLY PROCESSED.
ELECTRIC BILL
LA QUINTA PALMS HOA
c/o FIRST SERVICE RESIDENTIAL
P.O. BOX 62496
IRVINE, CA 92602
PB 0.00
CUR 146.95
DUE 146.95
Contract Acet. No.: 50056681
Service Location: 79355 HORIZON PALMS CIR
LA QUINTA CA
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Contractor Name: 76/G��
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State Lic:%j;54 7,L City Bus Lie:
Arch/Eng Name:
Address:
City, St, Zip
Telephone:
Email:
State Lie: City Bus Lie:
New SFD Construction:
Conditioned Space
Garage
Patio/Porch
Fire Sprinklers
Construction Type:
Grading:
Bedrooms: I Stories:
78495 CALLE TAMPICO
LA QUINTA, CA 92253
760-777-7000
SF
SF
SF
SF
Occupancy: I
# Units: